Nurse Managers Embrace Soft Skills for Better Outcomes

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Emotional Intellgience NurseManagement and leadership skills have evolved from broad-shouldered to broader concepts.

In the old days, only alpha-male types needed to apply to be managers. The more iron-handed the leader, the higher was his place in the hierarchy.

But today the manager with the hardest heart is rapidly being eclipsed by the manager with the best soft skills, and health care is no exception.

According to Daniel Goleman — whose 1995 book “Emotional Intelligence: Why It Can Matter More Then IQ” has spawned a significant shift in management styles — leaders have emotional intelligence if they combine empathy and social skills with strong motivation and self-regulation and ample self-awareness. The better the manager’s ability to employ these soft skills, the more likely they will lead others successfully.

Emotional intelligence in nursing leadership

For nurse managers and executives, there are quantifiable reasons why soft skills are a must. Clinical skills are important, but now the first order of business is to make patients happy about their outcomes, make reimbursement sources happy enough with those outcomes to continue funding and to make nurses happy enough to stay on the job.

“Before hiring nurse leaders,” writes American Nurse Today, “executives need to assess not only leadership credentials but how the nurse leader communicates, collaborates, and makes decisions in an interdisciplinary team environment and in situations that often can be stressful and chaotic.”

Soft skills have become so important that the U.S. Department of Labor has become a leading authority on their implementation. It identifies among soft skills:

  • Communication
  • Enthusiasm/attitude
  • Teamwork
  • Networking
  • Problem solving/critical thinking
  • Professionalism

The emphasis on soft skills can be traced to Goleman’s book, which is generally credited with having coined the term emotional intelligence.

Emotional intelligence and leadership styles

Emotional intelligence is more than an attitude that can be added to an otherwise austere management style. Emotional intelligence often is the management style, which the Harvard Business Review established soon after Goleman’s book was published by calling EQ “a revolutionary, paradigm-shattering idea.”

Goleman’s book has been instrumental in the business world’s increasing embrace of transformational management, which is geared to long-range planning and striving for loftier goals, including emotional intelligence. But there is resistance because the approach doesn’t always yield short-term financial benefits.

Many companies therefore still emphasize the traditional transactional approach, which is based on efficiency. It is intended primarily to make the trains run smoothly at low cost and is less concerned with care and maintenance of the facilitators.

But the transactional approach isn’t proving to make as much sense in the long run.

Given the nature of science and the difficulties of assessing ongoing health insurance changes, the emphasis in health care is decidedly long term, and that’s one of the reasons emotional intelligence is being stressed.

Emotional intelligence in health care

In wide-ranging surveys conducted by the University of Wisconsin and the University of Illinois involving several nurse managers working in six large Midwestern health systems, emotional intelligence, especially that of nurse managers, was correlated with positive processes in health care environments and positive institutional outcomes.

Those are all matters of long-run cost effectiveness. Examples:

Nurse retention: Persuading nurses to stay on the job has become an area of emphasis as nurse shortages have been persistent. Programs that are largely examples of transformational management have proved effective at easing burdens that drive veteran nurses away and at creating programs that help new nurses stay the course. It is not uncommon for the cost of the turnover of one registered nurse to be in the area of $65,000 to $80,000, according to a report on And that often doesn’t account for the loss of the institutional knowledge of an experienced nurse.

Improved outcomes: Researchers at the University of Alberta looked at the connection between emotional intelligence and patient mortality. They found that nurse leaders with higher EQ experienced lower patient mortality rates at statistically significant levels.

Financial incentives: The American Nurse Today article noted that “the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) uses a patient survey that ultimately affects reimbursements to the hospital. The survey barely touches upon clinical skills. Most of the questions relate to soft skills, such as being treated with courtesy and respect and whether nurses listen to patients, explain things understandably and respond to calls for help.

So it’s inevitable that the health care system’s financial analysts increasingly believe in soft skills. That’s why nurse managers must make sure they’re on board, fostering a climate that emphasizes the importance of emotional intelligence. The American Nurse Today article urged nurse leaders to weigh soft skills in their hiring criteria and hone their own soft skills, as well as those of other veteran employees.

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